Local anaesthetic

fiona-f

I hope this isn't seen as a request for medical advice, nor as timewasting but I'd be interested in your views on something my colleagues and I were debating over lunch today (needless to say, none of us work in the medical sector)!

If you have a localised procedure, e.g. a cut that needs stitching, or a mole that needs to be removed or maybe even something much more intensive, then after the local anaesthetic wears off and it starts to hurt like hell, why don't they just give you another jab of the local instead of oral painkillers that don't have the same effect? Say two or three jabs a day for the next two days til it doesn't really hurt any more? That way the afflicted bit of you is nicely numb for a few days and you feel no pain at all, rather than having a stinging / aching / throbbing pain that is only slightly deadened by tablets? Is there a medical reason not to do this, such as will the LA prevent healing? Can you overdose on LA? Or is it just impractical, expensive? Could it ever be an option?

Thanks!

bleg

Practical reasons that stand out for me would be the cost involved, the complicated nature or anesthesia, time consuming, patient's fear of needles, possible adverse effects and the fact that oral analgesia is much easier for patients to use.

fiona-f

Thanks for your reply - it was one of those silly random debates that just lingers in the mind!

So if you were fine with needles and willing to pay extra, could it theoretically be an option? Or am I totally unrealistic in my unscientific attempts to remove all pain from the equation? If something is going to hurt like hell, numbness would seem to be a far more attractive option than pain and a Panadol every six hours!

Traumadoc

You can give post operative local or regional anaesthesia as an infusion, such as to bone graft donor sites and to amputation stumps or as in epidural anaesthesia for postoperative knee surgery.

They tend to be time consuming and have a side effect profile especially the epidurals. Nurses need to be trained etc so you need to be doing a lot of them.

bleg

fiona-f wrote: »

Thanks for your reply - it was one of those silly random debates that just lingers in the mind!

Not silly at all!

So if you were fine with needles and willing to pay extra, could it theoretically be an option? Or am I totally unrealistic in my unscientific attempts to remove all pain from the equation? If something is going to hurt like hell, numbness would seem to be a far more attractive option than pain and a Panadol every six hours!

Not a clue on the first part. There are stronger pain killers on the marked though. If you are in pain that is not being controlled you can and should tell somebody.

Delancey

Don't forget that the numbness you desire can also mean you could sustain an injury to the affected area and not know it - obvious example being a numbed hand you burn but dont feel - at the time that is

drkpower

Local can really only be used over a small area before the pain of being injected with the LA (potentially at multiple sites) starts to become a big problem, so the potential uses of LA as analgesia are limited (in major suture jobs - ie. hip replacements - the surgeon will inject a good healthy dose of LA into the suture wound at the end of the op to get the patient over the first few hours, but after that it is impractical). Most of the situations that would be amenable to LA being used as analgesia will, in the vast majority of cases, be amenable to decent oral analgesia.

For the few cases that could benefit, the reality is that it is far too much hassle and cost to have a nurse/doc inject a patient regularly with LA (either in Hospital or at their home) when oral analgesia will do nearly as well. And delancey's point above is well made; essentially leaving a particular area of the body semi-permanently anaesthetised is incredibly unsafe and unwise.